Provider Demographics
NPI:1083313621
Name:TEASCK, AMY LOUISE (RN)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:LOUISE
Last Name:TEASCK
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
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Mailing Address - Street 1:12600 WHITEWATER DR STE 100
Mailing Address - Street 2:
Mailing Address - City:MINNETONKA
Mailing Address - State:MN
Mailing Address - Zip Code:55343-9450
Mailing Address - Country:US
Mailing Address - Phone:529-935-7112
Mailing Address - Fax:952-935-7112
Practice Address - Street 1:603 9TH ST N
Practice Address - Street 2:
Practice Address - City:VIRGINIA
Practice Address - State:MN
Practice Address - Zip Code:55792-2319
Practice Address - Country:US
Practice Address - Phone:218-270-5288
Practice Address - Fax:218-270-5290
Is Sole Proprietor?:No
Enumeration Date:2023-03-02
Last Update Date:2024-03-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MN1483833163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health